Faye Abdellah, RN, Ed.D., Sc.D., FAAN, was the founding dean of the Graduate School of Nursing at the Uniformed Services University, Bethesda, MD. She was the first Deputy surgeon General of the U.S. Public Health Service. She developed a list of 21 unique nursing problems related to human needs in the 1960s. Her early writings contributed to the idea that nurses use a problem-solving approach to practice rather than merely following physician orders, complementing the 1965 statement from the American Nurses Association recommending baccalaureate education as entry into nursing practice.

Abdellah's 21 problems are actually a model describing the "arenas" or concerns of nursing, rather than a theory describing relationships among phenomena. In this way, distinguished the practice of nursing, with a focus on the 21 nursing problems, from the practice of medicine, with a focus on disease and cure. Although Abdellah spoke of the patient-centered approaches, she wrote of nurses identifying and solving specific problems. This identification and classification of problems was called the typology of 21 nursing problems. Abdellah's typology was divided into three areas:

(1) The physical, sociological, and emotional needs of the patient;(2) The types of interpersonal relationships between the nurse and the patient; and(3) The common elements of patient care.

Adbellah and her colleagues thought the typology would provide a method to evaluate a student's experiences and also a method to evaluate a nurse's competency based on outcome measures.

Abdellah's Typology of 21 Nursing Problems:

1. To promote good hygiene and physical comfort2. To promote optimal activity, exercise, rest, and sleep3. To promote safety through prevention of accidents, injury, or other trauma and through the prevention of the spread of infection4. To maintain good body mechanics and prevent and correct deformities5. To facilitate the maintenance of a supply of oxygen to all body cells6. To facilitate the maintenance of nutrition of all body cells7. To facilitate the maintenance of elimination8. To facilitate the maintenance of fluid and electrolyte balance9. To recognize the physiologic responses of the body to disease conditions10. To facilitate the maintenance of regulatory mechanisms and functions11. To facilitate the maintenance of sensory function12. To identify and accept positive and negative expressions, feelings, and reactions13. To identify and accept the interrelatedness of emotions and organic illness14. To facilitate the maintenance of effective verbal and nonverbal communication15. To promote the development of productive interpersonal relationships16. To facilitate progress toward achievement of personal spiritual goals17. To create and maintain a therapeutic environment18. To facilitate awareness of self as an individual with varying physical, emotional, and developmental needs19. To accept the optimum possible goals in light of physical and emotional limitations20. To use community resources as an aid in resolving problems arising from illness21. To understand the role of social problems as influencing factors in the cause of illness

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